NPI | 1578543989 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID M5280) |
Additional Taxonomies | 207PE0005X Emergency Medicine Undersea and Hyperbaric Medicine (Licence: ID M5280) |
Enumeration Date | 2006-01-20 |
Last Update Date | 2007-07-08 |